Facility Evaluation Report

At approximately 11:05 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Case Management inspection and met with Administrator, Nayely Jimenez. The facility submitted one (1) Incident Report (IR) for Client 1 (C1) for a medication error.

The IR stated that on Tuesday,11/4/2025 staff member S1 gave client C1 the wrong medication. IR states that during the 1530 medication pass, C1 was given their 1200 medication in error. Facility immediately contacted C1's primary care physician (PCP) and poison control. Staff at the facility followed PCP and poison controls instructions and monitored C1 for any adverse reactions. C1 had no adverse reactions and there have been no residual side effects.

The facility will be cited for this deficiency.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Jimenez. Signature on form confirms receipt of documents